Computed Tomography-Guided Lumbar Puncture: Advantages and Disadvantages

J Comput Assist Tomogr. 2022 Mar-Apr;46(2):269-273. doi: 10.1097/RCT.0000000000001260.

Abstract

Objective: This study aimed to evaluate the utility of computed tomography (CT) guidance in difficult lumbar puncture (LP) cases, which had a history of at least one unsuccessful blind attempt at LP (no imaging guidance), and to note potential advantages and disadvantages of the use of CT guidance.

Methods: In total, 32 CT-guided LP procedures performed between June 2019 and March 2021 were included. All LP indications were recorded. The procedures where the cerebrospinal fluid flow was provided by a single puncture were evaluated as "primary technical success." "Secondary technical success" corresponded with the procedures in which additional puncture was necessary for the cerebrospinal fluid flow.

Results: Intrathecal nusinersen injections due to spinal muscular atrophy constituted the largest procedure group of this study. Among 32 procedures, primary and secondary technical success rates were 78.12% and 28.57%, respectively. There were no major procedural complications.

Conclusions: Computed tomography-guided LP is an effective interventional technique offering an alternative approach in the setting of difficult LP procedures.

MeSH terms

  • Humans
  • Injections, Spinal / methods
  • Muscular Atrophy, Spinal* / drug therapy
  • Spinal Puncture*
  • Tomography, X-Ray Computed